NPIMap

Organization Active NPI

Bryan Wieck MD PA

  • Psychiatry Physician
  • Wichita Falls, TX
National Provider Identifier
1346517182
Registry record updated Mar 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
J0361 Issued in TX
Legal business name
BRYAN WIECK MD PA
Practice address
1410 8TH St
Wichita Falls, TX 76301-3105
Phone
(940) 264-8818
Fax
(940) 264-8819
NPI assigned
Nov 22, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Bryan R Wieck, MDNPI 1962401166
Title
Owner
Phone
(940) 264-8818

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X J0361 TX Primary

Addresses

Primary practice location

1410 8TH St
Wichita Falls, TX 76301-3105

Mailing address

1410 8TH St
Wichita Falls, TX 76301-3105
Phone (940) 264-8818

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120426000177 TX Part B Supplier - Clinic/Group Practice 4880856558 Receives reassigned benefits from 1 practitioner
Practice locations: Wichita Falls, TX

National Provider Directory

National Provider Directory

Locations

1410 8th St
Wichita Falls, TX 76301
Phone (940) 264-8818

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 14

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1321920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740960000000",
    "number": "1346517182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1410 8TH ST",
            "city": "WICHITA FALLS",
            "state": "TX",
            "postal_code": "763013105",
            "telephone_number": "940-264-8818",
            "fax_number": "940-264-8819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1410 8TH ST",
            "city": "WICHITA FALLS",
            "state": "TX",
            "postal_code": "763013105",
            "telephone_number": "940-264-8818",
            "fax_number": "940-264-8819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRYAN WIECK MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-22",
        "last_updated": "2025-03-03",
        "certification_date": "2025-03-03",
        "status": "A",
        "authorized_official_last_name": "WIECK",
        "authorized_official_first_name": "BRYAN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "940-264-8818",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TX",
            "license": "J0361",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita Falls, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.